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How do you know when Binge Drinking is Really a Problem?

My friend’s daughter Anna* is expecting her first child in a few months. Once a heavy drinker, she stopped consuming any alcoholic beverages when she and her husband Len began trying to get pregnant. “I’ve read about how bad alcohol is for a fetus,” she said. “I want to give this baby everything I can to have a healthy and satisfying life, and I sure don’t want to start out by causing brain damage by drinking. I can do without it for as long as I need to if that’s the trade-off.”

Len, on the other hand, doesn’t see any reason that he should join Anna in abstaining. “Alcohol isn’t going through my body into the baby’s,” he says. But Anna worries about Len’s drinking. Although he does not get drunk every night, he does binge drink on weekends. “It gets a bit embarrassing,” she says. “He says and does things he wouldn’t say or do if he wasn’t drunk.” Anna says she can see when he’s gone over the line into drunkenness by a particular look in his eyes. She loves Len and thinks he will be a terrific dad, but she worries that the drinking will affect their child psychologically. Len thinks she’s wrong. “It’s just how I unwind,” he says.

For some years, I have been concerned about the problem of binge drinking among college students (my most recent article on the subject will be coming out sometime in the next year in the Journal of College Student Psychotherapy). But a number of factors, including responses to my post on Mother’s Day, concerns expressed by a number of clients, and conversations with a variety of friends, colleagues and relatives, made me start to pay attention to the issue of binge drinking in adults.

It turns out that, although it is a problem among college students, 70% of binge drinking episodes involve adults age 26 years and older. The Centers for Disease Control says that it is the most common pattern of excessive alcohol use in the United States. It is a serious concern in many countries around the world. And yet it may not be considered alcoholism, since according to this same report, many people who binge drink are not alcohol dependent.

Just for the record, the National Institute on Alcohol Abuse and Alcoholism defines binge drinking as the consumption of enough alcoholic beverages within a 2 hour period to bring blood alcohol concentration levels to 0.08 grams per deci-liter. For women this usually means an average of four drinks, and for men an average of five, although binge drinkers are seldom very accurate about the number of drinks they consume in a two hour period, let alone in the course of an evening.

Alcoholism, on the other hand, is defined as including symptoms such as:

Craving—A strong need, or urge, to drink.

Loss of control—Not being able to stop drinking once drinking has begun.

Dependence—Withdrawal symptoms, such as nausea, sweating, shakiness, and negative emotional states such as anxiety, after stopping drinking.

Tolerance—The need to drink greater amounts of alcohol to feel the same effect.

I guess one question is, does it matter if binge drinking is alcoholism?

Since it turns out that even a single episode of binge drinking can be highly destructive. Here is a list of just some health problems associated with binge drinking from the Centers for Disease Control:

And just this week came a report of a new study showing that a single episode of binge drinking can cause bacteria to leak from the gut into the bloodstream with potential damage to a person’s immune system.

I’m just starting to research these questions. I’d love to know about your experiences and about what you think drives binge drinking. Also, if you know of studies, articles or books that try to explain why people continue to binge drink despite the obvious dangers, I’d be very grateful if you would post those as well.

Hibell, B., Andersson, B., Ahlström, S., Balakireva, O., Bjarnason, T., Kokkevi, A., et al. (2004). The ESPAD Report 2003: Alcohol and other drug use among students in 35 European countries. Stockholm: The Swedish Council for Information on Alcohol and Other Drugs (CAN).

I drank like a fish (so to speak) on the weekends for perhaps 20 years. I would drink and pass out and drink and pass out all through the weekend. Monday was horrible but I managed to get through it most of the time. Although, I usually had attendance problems at work.
Then the hangovers got worse, I drank to relieve them, only now I was not stopping on Sunday evening. That became progressively worse until I was drunk all week and would sober up for a day or two and then go for another week.
In short, I plateaued for about two decades and then I took a fairly rapid nose dive in the following 5 years.

The thing I would mention is that I only drank on the weekends because I knew right at the beginning (before, or shortly after, I left high school) that I could decide when to drink, but not how much. Binging was a control mechanism.

One of the less damaging things about being a binge drinker is that it gives an acute fatty liver a chance to regenerate. On the other hand, I think drinking until you pass out and staying like for two or three days does more neural damage than just drinking a six pack or two every night.

I would also add that I have never met an alcoholic who did not know alcohol was hurting him (who was in denial). They all knew, so did I. That is why we develop patterns, to give ourselves as much control over our behaviors as we coucl.